The Briefing provides an at-a-glance view of some important developments in the information universe surrounding COVID-19. The views presented here are solely those of ECRI Horizon Scanning and have not been vetted by other stakeholders.

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Oral antiviral drugs, such as molnupiravir (see Topics to Watch), are in development, but none are yet available. Incentive programs are aiming to increase vaccination uptake (see Topics to Watch), but the United States is not on track to meet the July 4 aspiration of 70% of adults having received at least one vaccine dose. In addition, the rise of the Delta variant in the United States could lead to surges in COVID-19 cases among the unvaccinated.

Two new National Institutes of Health (NIH) research initiatives aim to combat these situations and to speed the progress of biomedical innovations in general. The first, the Antiviral Program for Pandemics, will invest $3 billion from the American Rescue Plan to fund discovery, development, and manufacturing of oral antivirals, including molnupiravir. The second, the Advanced Research Projects Agency for Health, aims to expand the lessons learned from the success of accelerated vaccine development to yield breakthroughs in other diseases, such as Alzheimer’s disease and cancer.

Incentive Programs to Increase COVID-19 Vaccine Uptake

At a Glance

  • Vaccine incentive programs are intended to increase community uptake of COVID-19 vaccines and to reduce infection spread, hospitalizations, mortality rates, and health care costs related to COVID-19.
  • These programs vary but generally help the public gain access to vaccination sites or receive a reward (eg, lottery entry, gift cards) after getting vaccinated.
  • Some companies offer additional incentives, such as providing paid time off for employees who are not yet vaccinated to get their shots.
  • Results from the statewide vaccination lotteries and other financial incentives show an encouraging increase in vaccination rates in California and Ohio. The impact of the lottery program on Maryland vaccination rates is still under investigation.

Molnupiravir to Treat Outpatient Mild to Moderate COVID-19

At a Glance

  • Molnupiravir is an investigational oral nucleoside analogue prodrug that is being developed to treat mild to moderate COVID-19 in the outpatient setting.
  • Molnupiravir purportedly is converted in the body to a cytidine analogue that incorporates into viral RNA during replication and increases the error rate such that it renders the virus nonfunctional.
  • Its developers are conducting a phase 2/3, randomized, placebo-controlled trial enrolling 1850 patients with mild to moderate COVID-19 in over 100 locations inside and outside of the United States. The trial’s estimated primary completion date is in October 2021.
  • The US government announced plans to purchase 1.7 million courses of molnupiravir to treat COVID-19 if the drug receives emergency use authorization (EUA) or FDA approval.

Commentary in this COVID-19 Scan reflects preliminary views of ECRI Horizon Scanning and internal ECRI stakeholders.
The information contained in this document has not been vetted by other stakeholders.

We welcome your comments on this Scan. Send them by email to [email protected].

Posted: July 7, 2021

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